A New Smile

(Page 2)

When I was 27, a Massachusetts state trooper broke one of my front teeth. It was New Year's Eve day. I was driving my old Volkswagen Beetle from Boston to Storrs, where my youngest brother attended UConn and was having a party. Snow was coming down heavily and the windshield wiper motor gave out on the Massachusetts Turnpike near Sturbridge. It was unsafe to drive on. Actually, it was impossible to drive on. I left the car, determined to hitchhike to Storrs, and to worry about the car on another day.

I was arrested, charged with hitchhiking and jailed. I did not have the cash to post bond and they would not take a check. I was a noisy inmate, demanding the telephone every few minutes. My brother's line was busy. Eventually, the arresting officer walked into the cellblock and beckoned me close to the bars.

He reached through and grabbed me by the sweater, near the throat, and yanked hard, slamming my face against the bars. He swore at me, told me to adjust to the fact that I would be spending the night. He left. I tasted blood, and a piece of tooth.

I banged on the metal walls and yelled some more, and another officer entered the cellblock.

"Your buddy out there just broke my tooth," I told him.

"Oh, boy. That isn't kosher," he responded. I was let out, permitted to wash out my mouth, allowed to sit by the phone and call and call until I got through to my brother. His roommate, Jim, came and fetched me. The hitchhiking charge disappeared. I later filed a lawsuit, which came to nothing, in the end.

Days after the incident, the tooth was repaired by my parents' dentist. It needed a crown, really, but that was too expensive for me even then. I had saved the broken-off piece of tooth and the dentist cemented it back in place. He said the repair work would probably not last more than a few years.

The piece finally came loose again 20 years later, just months ago, falling into my mouth on a January morning as I brushed my teeth.

I remember peering into the mirror and thinking that it really didn't make much difference. Time had taken an inexplicable toll on my smile, and the broken tooth fit right in with its jagged, worn-down neighbors.

I don't know exactly when I lost my smile. Of course, it did not happen in a moment, but it could not have been that long ago relatively. I have a picture from 1995, a year I remember with some fondness; I am smiling in the photo and the teeth are there. If I still had my 1995 smile at the beginning of 2001, my dentist would not have said to me, at the end of a routine checkup and cleaning, "We can fix your teeth, you know. We can give you a great smile."

I took this somewhat personally.

"What do you mean?" I said, though, on some level, I am sure I knew exactly what he meant. I had to have known. I look now at pictures of me taken in 2001 and there is just the hint of a smile. I had evolved a new expression to show happiness or well-being, at least for the camera. In the photos, my lips part and the corners of my mouth turn up. But there are no teeth.

In the mirror, that day in 2001, I confronted my teeth. The view was less than horrifying but more than worrisome. The enamel, the material that is supposed to protect teeth for a lifetime, was gone, my dentist said. We speculated why. I said I did not grind my teeth, as far as I knew. He did not argue with me, but we could not otherwise account for the wear.

The cause was not pinned down, at least in my mind, but it didn't really matter much. My teeth, in particular my upper teeth, were seriously worn and would only get worse. I agreed to consider their reconstruction. My dentist took impressions to be made into molds, which would suggest the course of treatment.

After looking at the molds, my dentist said I could have my smile again, better than ever. I just needed 12 porcelain crowns to cover my upper teeth, and whatever ancillary work might be needed to put them in. The price for the crowns was $800 apiece. I did the math - $9,600, to start with.

"That's simply not going to happen," I said.

We went on to discuss my dental insurance, which conceivably could have paid up to $1,200 of the cost, the maximum allowed on my plan for a calendar year. It still seemed an insane expense to bear, an extravagance for a single parent with a son in parochial school, and college tuition payments looming in the not-so-distant future.

The insurance company rejected the possibility of a claim, in any case. The work was cosmetic, as unnecessary as braces had been in my childhood.

At later, routine appointments, I inquired, without any real hope, about the possibility of less expensive alternatives. I am sure they would have been offered if feasible. My dentist said, with regret, there was no such solution he could recommend. Fixing just some of the problem would cause others. My teeth were an all-or-nothing proposition.

I did some checking around, halfheartedly, with other dentists. The price quoted to me was about average for around here, as far as I could determine. There were no sales, no "buy one, get one free" marketing gimmicks in dentistry.

I put my teeth out of my mind, as much as possible, even when brushing them. If they showed up badly in a photo, I retouched it - thank goodness for digital imaging. I wondered, sarcastically, if insurance would pay for any percentage of the dentures I was surely going to need in a few years.


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For more information on traveling outside the country for medical care, see: Beauty from Afar

White water at La Paz Waterfall Gardens in Vara Blanca, about an hour by bus from downtown San Jose, Costa Rica. A volcano, a drive through coffee country, a jungle river excursion and a hike through La Paz, which includes a hummingbird garden, the world's largest butterfly observatory and a spectacular three kilometer hike through rain forest and the mists of five waterfalls, is all part of a $79 day trip -- lunch included. Ten days in Costa Rica cost the author about $1,000 for hotels, meals, sightseeing, souvenirs, tips and incidental travel. Those who don't mind roughing it a bit can find rooms for as little as $15 a night; there are also luxury accommodations for business travelers and vacationers. The Pacific Coast is about a three-hour drive from San Jose; the Caribbean is about two hours away, to the east.

Photo by Jeff Schult .

The Butterflies of La Paz (story, photos)

Home and Abroad: Comparative Cost Chart

Prisma Cosmetics Dentistry (and Blog)

Las Cumbres Inn/Surgical Retreat